Melasma
- Pigmentation affecting cheeks, forehead, upper lip, nose and chin
- More common in females
- More noticeable in the summer and improves during winter months
- Birth control pills and hormone therapy can be a trigger
- Management is challenging
- A combination of therapies provides best clinical outcome
- A mixture of hydroquinone, hydrocortisone and tretinoin can be safely and effectively used for limited amount of time
- Non-hydroquinone skin lighteners are an alternative to patients that don’t tolerate or have allergy to hydroquinone